Diarrhea
What is diarrhea?
Diarrhea means having bowel movements more often than normal, and the stool is loose or watery. It can happen for a short period of time or continue over several days. In patients with cancer, diarrhea is most often caused by treatment, but in some cases, it can be caused by cancer itself. If diarrhea remains uncontrolled for too long, it can cause the body to lose too much water and important electrolytes.
What does diarrhea look like?
Diarrhea results in frequent loose or watery stools, sudden urgency to use the bathroom, stomach cramping, or a feeling that it is hard to hold a bowel movement. Some patients also have gas, rectal irritation, dizziness, fever, blood or mucus in the stool, or weight loss. Diarrhea is often graded by how many more bowel movements a person has than usual. Mild diarrhea can often be managed at home, but severe diarrhea can be dangerous and may require hospital treatment.
Who gets diarrhea?
Common causes of diarrhea include infections, certain foods, antibiotics, stress, bowel problems, and other medicines. In patients with cancer, diarrhea can be a common side effect of chemotherapy, immunotherapy, radiation therapy, targeted therapy, surgery involving the digestive tract, and stem cell transplant. Not every cancer treatment carries the same risk of diarrhea. Some chemotherapy drugs and targeted therapies are more likely to cause diarrhea than others, and prior bowel problems or infections can also increase the risk.
How is diarrhea prevented?
Patients who are receiving treatments that carry a high risk for diarrhea should drink plenty of fluids, eat small meals, and choose foods that are easier on the stomach. Low-fiber foods such as white bread, pasta, rice, applesauce, bananas, crackers, potatoes, and soup are often better tolerated when diarrhea starts or is expected. It also helps to avoid foods and drinks that can make diarrhea worse, such as greasy foods, spicy foods, alcohol, caffeine, some fruit juices, and sometimes milk or dairy products.
How is diarrhea treated?
For many patients with treatment-related diarrhea, doctors may recommend anti-diarrhea medicines such as loperamide (Imodium®), which is available over the counter (OTC), or diphenoxylate/atropine (Lomotil®). These medications help slow the activity of the bowels, which allows more fluid to be absorbed from the gut and decreases the volume of stool.
If diarrhea is severe, the cancer treatment may need to be held for a period of time until symptoms improve. IV fluids may also need to be given to replace what the body has lost. After resolution, the dose of the treatment may need to be adjusted as well.
When diarrhea is related to immunotherapy, treatment may be slightly different from usual chemotherapy-related diarrhea. Because immune checkpoint inhibitors can cause inflammation in the colon, anti-inflammatory treatments, such as prednisone, may need to be used in addition to standard anti-diarrhea medicine.
NOTE: Treatment Options listed below are not all-inclusive. Other treatments may be available. ChemoExperts provides drug information and does not recommend any one treatment over another. Only your Doctor can choose which therapy is appropriate for you.
Treatment Options
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